Conservative treatment of suprahepatic pseudoaneurysm in a pediatric patient

Suprahepatic and inferior vena cava (IVC) pseudoaneurysms are rare in children. Most cases in adults are treated surgically due to the high risk of rupture.

Seven-year-old girl referred for a thoracic-abdominal trauma of unknown origin. Hemodynamically stable, with a hemoglobin level of 9.1 g/dl. An emergency CT scan was performed, showing a pseudoaneurysm at the confluence of the IVC with the middle and left suprahepatic veins, with active bleeding contained by the hepatic capsule. Given the hemodynamic stability and surgical risk, conservative treatment was decided upon. CT-scan at 24 hours showed cessation of bleeding. A control CT-scan was performed one month, three months, one year, and one and a half years later, showing the lesion had disappeared.

Conservative treatment of suprahepatic vein pseudoaneurysm/ICV is feasible in the case of hemodynamic stability provided that strict clinical and radiological surveillance is maintained.